Health Insurance – What’s Special About It?

In order to understand your health insurance coverage, you must first be able to identify what type of health plan you may have. There are 3 different health plans available to consumers:PRIVATE HEALTH INSURANCE PLANS AVAILABLE
Typically, a health insurance benefit plan is a contract between your employer and a third party (an insurance company). These contracts vary widely depending on the benefits and coverage levels negotiated by your employer. Oftentimes, the benefits information provided by your health insurance plan is confusing-leaving you unsure of what speech and/or hearing services will or won’t be covered.Remember, the benefits booklet you receive is merely a summary of benefits-not actual contract language. You may need to examine the policy or contract to truly understand your health insurance plan’s coverage and limitations. The policy or contract can be obtained from your benefits manager. It is vital that you review the speech and hearing benefits information provided by your health plan and employer before you receive services.MEDICAID
Medicaid provides medical assistance to certain individuals and families with low incomes and resources. It is jointly funded by the Federal and State governments. Although the federal government establishes national guidelines, each state has the authority to establish its own eligibility standards for health insurance, determine the type and duration and scope of services for health insurance, set the rates of payments and administer the program. As part of the plan, the state must offer medical assistance for certain basic services to those living under the poverty level. For adults over the age of 21, the states are not required to provide speech-language pathology and audiology services.To ascertain the coverage in your health insurance state, you should contact the state Medicaid agency.For children under the age of 21, the Medicaid law requires the states to provide hearing screenings and assessment of communication skills and language development as part of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) service. Based on the findings of this screening, the state must provide services and related devices such as hearing aids and AAC devices to treat or ameliorate the condition. Medicaid recognizes the importance of school-based speech-language pathology and audiology services although it is a medical assistance program. The federal Medicaid program actually encourages states to use their Medicaid programs to help pay for certain health care and health insurance services delivered in the schools if federal regulations are followed. Contact your local school district to inquire if they participate in the Medicaid program.MEDICARE
In 1965, the Social Security Act established both Medicare and Medicaid. Medicare is the federal health insurance program that is designated for those people who are 65+ years of age. Although directed towards a specific age bracket, Medicare plans are also applicable to certain disabled people.Medicare covers most health insurance services for assessing and treating speech, language, swallowing, hearing and balance disorders. It covers most hearing examinations but it does not cover hearing aids or tests for hearing aids.
Medicare has two major parts: Part A is hospital insurance and is financed through federal taxes while Part B is supplementary medical insurance and has a monthly
premium.Medicare Part A helps cover hospital stays, limited skilled nursing facility care when daily skilled services are needed, home health care and hospice care. Most services for speech, language, hearing and related disorders such as those effecting swallowing and balance are covered in these settings. Medicare regulations allow rehabilitation services when significant functional progress is expected and/or maintenance care is needed.Medicare Part B helps cover physician services, audiology testing services, outpatient hospital services, rehabilitation agency services and comprehensive outpatient rehabilitation facility services. Service for speech and related disorders are covered in these settings. Thanks for reading.

What is a Normal Health Insurance Premium?

There are two primary factors affecting health insurance policy rates and premiums The first item is your own health history as well as your family health. The number two cause is age.Insurance companies take into account both family history and personal health when calculating premiums for life and health insurance. Health insurance companies usually request blood and urine samples to verify that there are no pre-existing health conditions.The majority of insurance companies provide plans with costlier premiums to individuals with serious or chronic conditions like coronary disease, cancer, diabetes or elevated blood pressure.People who have perfect health will notice that the standard term policy might have slightly more premiums. This is because such policies cover most all health risks. For clients who can afford costly premiums but do not have the time to lower their risk factors, this policy would surely work.People shopping for insurance can check out quotes online to help them find the policy that’s right for them. Also, folks are able to go to the FAQ section to find out what is expected of them to get the best health coverage plan.The variability of family history and health can have an adverse effect on policyholders with low insurance premiums. So these folks need to pay a much higher premium total.Average health insurance premiums skyrocketed to the tune of an annual growth of 10 in the first years of the decade.Eight percent. Premium growth surprisingly stayed strong in 2003, then decreased to 8% in the following year. Since 1982, medical insurance premium rates have risen on average 7% per year. For premiums having to do with health insurance, a typical occurrence is a volatile business cycleHealth insurance had six during 1992.Three percent of compensation for employers in private industries. As if September of 2007, medical benefits made up a significant part of benefits offered by employers. Number 7 is included.One percent of the total compensation. This is what helps companies with more than 500 employees get good health insurance and compensation sharing.Once the price went up most companies pass the increase on to the employees. This has only moved the issue around.A population that is getting older has a big impact on the future of our health care industry in the US. The elderly are the most high-cost demographic groups in terms of pharmaceutical treatment, in-patient care stays, and physician visits.The primary reason for increases in premiums for medical insurance is the increasing age of the population. Since at a minimum, Medicare tries to cover services for 22% of the entire population, the increasing number of older people creates problems for the Program.Paying monthly premiums in a timely manner is important for people. You may qualify for a discount if you have never turned in a claim. It is also very important for policyholders to do a comparison on health insurance plans. And so afterward, they can choose from amongst the array what they think as the best plan.Because of the increasing cost of health care in the U.S., medical insurance is now a critical issue. Therefore, typical health insurance premiums, which are easy to pay, can ensure insurance coverage for most Americans.

Health Insurance Regulations

The First Few Years of State-Run Health Insurance RegulationsAlthough regulations relating to health insurance were identified and put forward by Congress as far back as the 1930s and 1940s, they were never ratified at that time. On the other hand, the 1965 Social Security Amendments Act brought about Medicare to take care of the needs of families earning little. In 1993, the United States’ president at that time, Bill Clinton, initiated the bill of universal cover, but this also died down.The regulations governing Medicare was made extensive in 1973 to include the medical needs of those under the ages of sixty-five, but with serious disabilities requiring serious medical attention. In 1988, Congress again made this scheme extensive to cover prescription medications. This bill became very unpopular and it was abolished in 1989 because funding solely came from taxing the elderly. Again in 2003, improvements were made on Medicare and the regulations governing it were modified to include prescription medications that had become very expensive and this was directly related to prescription medications that were much needed by the elderly.If truth has to be told, the freezes in income that were required by law during the period of the Second World War was what principally caused employers to include health insurance in the pay pack of employees. This was thought to be a remedy to attract the much needed labour. This practice was kept alive and regulated by the 1985 Consolidated Omnibus Budget Reconciliation Act. This basically took care of the medical needs of those who were dependent on an insurance scheme or employees who were no longer working.The main aims of the 1985 Consolidated Omnibus Budget Reconciliation Act was to make sure that if an employee was no longer active in service, those who were still dependent on him should continue receiving any benefits that could have been open to them, had the employee been in active service. 1996 saw the introduction of the Health Insurance Portability Act and this act was meant to take care of the health insurance needs of a workman who was no longer working, but who was in a process of getting hooked to another employment.Given the fact that each state has been given the freedom to administer its own health insurance plans as it deems reasonable and fit for its citizens, some states such as Oregon have come up with rules and regulations to take care of the needs of those who have a sure and particular form of disability, rather than trying to see if this beneficiary will qualify for the health insurance benefits available. An example of this is the Oregon Health Plan.In 1996, the Mental Health Parity Act was passed and this act acknowledged the awareness and frequency of psychological illnesses and it compelled every employee with fifty or more employees to provide health insurance to take care of psychological illnesses as any other health insurance scheme will do for conditions with physical illnesses. Yet still, employers were able to get of out of this by totally carrying on the burden health insurance to their employees and leaving the employees to take care of this in person. Still, there was nothing on the part of the legislative arm to redress this position of employers.Health Insurance Regulations in CaliforniaIn California, insurance is defined as an agreement under which the insurer agrees to take care of the loss or injury suffered by the insured as a result of some unknown cause. Any fraud on insurance is considered a very serious criminal offence in California.The administration in California is doing much to protect the interests of the insured from the economic prowess of these insurers. What is being done is that a scheme is being advocated in which the insured will have the option of taking care of his or her own health insurance needs. This is also to avoid situations in which insurers have been known to have refrained from taking their responsibilities of indemnifying the insured. It is even thought that there should be a nationwide scheme in which every form of health insurance will be one and the same. But this thought is considered farfetched because the expenses needed to administer it may be difficult to be provided.